To estimate the association between the pre-pregnancy Body Mass Index (BMI) and the weight categories with the risk of cesarean section in Peruvian women. Methods: A Case-control study was conducted. The present study included 13 734 pregnant women (cases=4578 and controls=9156). The pre-pregnancy BMI and overweight and obesity status were the main risk factors. Logistic regression was used to assess the association between the main exposures and cesarean section. Results: Higher BMI values were associated with cesarean delivery (adjusted Odds Ratio (aOR): 1.081, 95% CI 1.067-1.095, P<0.001). When bodyweight status was considered, women with overweight (aOR: 1.461, 95% IC 1.172-1.823, P: 0.001) and obesity (OR: 1.810, 95% IC 1.578-2.076, P<0.001) during the pre-pregnancy had a higher likelihood of cesarean section compared to those with normal weight. Conclusion: Pre-pregnancy higher BMI values, particularly those of overweight and obesity status were independent risks for cesarean delivery in Peruvian women.
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